<!DOCTYPE html>
<!--
To change this license header, choose License Headers in Project Properties.
To change this template file, choose Tools | Templates
and open the template in the editor.
-->
<html>
    <head>
        <title>TODO supply a title</title>
        <meta charset="UTF-8">
        <meta name="viewport" content="width=device-width">
        <!-- CSS Begins       -->
        <link rel="stylesheet" href="css/bootstrap.css">
        <link rel="stylesheet" href="css/bootstrap.min.css">
        <!--   End of CSS            -->
        <!----------Scripts--------->
        <script src="js/jquery-1.10.2.min.js" type="text/javascript"></script>
        <script src="js/bootstrap.min.js" type="text/javascript"></script>
        <script src="js/handlebars-v1.3.0.js" type="text/javascript"></script>
        <script src="js/jquery.cookie.js" type="text/javascript"></script>
        <script src="js/handlebars-v1.3.0.js" type="text/javascript"></script>
        <script src="js/custom.js" type="text/javascript"></script>
        <!-----End of Scripts---->

        <!----Custom Script----->
        <script type="text/javascript" >
            $(function()
            {
                //---Loading the Navbar
                includes("navbar_Templ", {}, "#navbar");
                //includes("navbar2_Templ" {},"#test")

            });
        </script>
        <!----End of Custom Script----->

    </head>
    <body>
        <div class="row">
            <div id="navbar" style="height:100px"></div>
            <!--            <div id="test" style="height:100px"></div>-->
        </div>
        <br>
        <br>
        <br>
        <br>
        <div class="row" style="">
            <div class="col-lg-6 col-lg-offset-3">
                <div id="msgPane"></div>
                <div class="well">
                    <form method="post" action="#" id="customerForm" class="bs-example form-horizontal">
                        <fieldset>
                            <legend>Customer Registration</legend>

                            <div class="form-group">
                                <label for="Name" class="col-lg-3 control-label">Name : </label>
                                <div class="col-lg-7">
                                    <input type="text" class="form-control" required name="name" placeholder="Enter your full name" id="NameTxt"/>
                                </div>
                            </div>

                            <div class="form-group">
                                <label for="Email" class="col-lg-3 control-label">E-mail Address : </label>
                                <div class="col-lg-7">
                                    <input type="email" class="form-control" required name="email" placeholder="Enter your E-mail Address" id="EmailTxt"/>
                                </div>
                            </div>

                            <div class="form-group">
                                <label for="MobileNumber" class="col-lg-3 control-label">Mobile Number : </label>
                                <div class="col-lg-7">
                                    <input type="text" class="form-control" required name="phonenumber" placeholder="Enter your Mobile Number" id="MobileNumberTxt"/>
                                </div>
                            </div>

                            <!--                            <div class="form-group">
                                                            <label for="DateOfBirth" class="col-lg-3 control-label">Date Of Birth : </label>
                                                            <div class="col-lg-7">
                                                                                        <input type="date" class="form-control" name="dob" id="DateOfBirthTxt"/>
                                                                <input type="text" class="form-control" name="dob" id="dob" placeholder="Click to select a date">
                                                            </div>
                                                        </div>-->

                            <!--                            <div class="form-group">
                                                            <label for="Gender" class="col-lg-3 control-label">Gender :</label>
                                                            <div class="col-lg-7">
                                                                <div class="radio-inline">
                                                                    <input type="radio" id="genderoptionM" name="gender" value="Male" checked="">Male
                                                                </div>
                                                                <div class="radio-inline">
                                                                    <input type="radio"  name="gender" value="Female" id="genderoptionF">Female
                                                                </div>
                                                            </div>
                                                        </div>-->

                            <div class="form-group">
                                <label for="Address" class="col-lg-3 control-label">Address:</label>
                                <div class="col-lg-7">
                                    <textarea class="form-control" rows="3" id="Address" name="address"></textarea>
                                </div>
                            </div>

                            <hr>

                            <div class="form-group">
                                <label for="Username" class="col-lg-3 control-label">Username : </label>
                                <div class="col-lg-7">
                                    <input type="text" class="form-control" required name="username" placeholder="Enter your Username" id="UsernameTxt"/>
                                </div>
                            </div>

                            <div class="form-group">
                                <label for="Password" class="col-lg-3 control-label">Password : </label>
                                <div class="col-lg-7">
                                    <input type="password" class="form-control" required name="password" placeholder="Enter your Password" id="PasswordTxt"/>
                                </div>
                            </div>

                            <div class="form-group">
                                <label for="ConfirmPassword" class="col-lg-3 control-label">Confirm Password : </label>
                                <div class="col-lg-7">
                                    <input type="password" class="form-control" required name="ConfirmPassword" placeholder="Enter your Password again" id="ConfirmPasswordTxt"/>
                                </div>
                            </div>
                            <!--
                            <div class="form-group">
                                <label for="SecurityQuestion" class="col-lg-3 control-label">Security Question : </label>
                                <div class="col-lg-7">
                                    <select name="securityquestion" class="form-control" id="SecurityQuestion">
                                    <option>Favourite Color</option>
                                    <option>Pet's Name</option>
                                    <option>Mother's maiden name</option>
                                    <option>Favourite Singer</option>
                                    </select>
                                </div>
                            </div>
            
                            <div class="form-group">
                                <label for="SecurityAnswer" class="col-lg-3 control-label">Answer : </label>
                                <div class="col-lg-7">
                                    <input type="text" placeholder="Enter answer for Security Question" class="form-control" name="SecurityAnswer" id="SecurityAnswerTxt"/>
                                </div>
                            </div>
                            --->
                            <div class="form-group">
                                <div class="col-lg-7 col-lg-offset-3">
                                    <button type="submit" name="button" value="Register" id="submitBtn" class="btn btn-primary">Register</button>&nbsp;&nbsp;
                                    <a href="login.html">Go back to Login Page</a>
                                </div>
                            </div>

                        </fieldset>
                    </form>
                </div>
            </div>
        </div>
    </body>
</html>
